Poisonings and intoxications in children account for almost 5% of pediatric intensive care unit admissions. Children of different ages occupy both ends of the poisoning spectrum of accidental and intentional exposures with the former accounting for 77% of the total. The plethora of drugs and toxins which are within easy reach of children, and a wide variety of symptoms and signs with which intoxicated children present, makes treating them a challenging task. Basics of resuscitation and supportive care as for any critically ill patient, decontamination, and assisted elimination techniques are of fundamental importance in managing intoxications. Large toxic doses and delay in institution of therapy may prompt additional interventions for elimination including extracorporeal therapy and use of antidotes. Mortality though infrequent is encountered in up to 0.7% of PICU admissions and is mainly due to the development of multi-organ failure.